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Neurology > Tumors of the CNS > Flashcards

Flashcards in Tumors of the CNS Deck (30):
1

Most frequent primary tumor of the CNS

Infiltrative astrocytoma

2

Risk factors for CNS tumors

- ionizing radiation
- immunosuppresion
- genetic syndromes

3

Do we need to know all of these hereditary syndromes assoc with brain cancer?

ask

4

Cerebreal perfusion pressure is the difference between

MAP and intracranial pressure. Intracranial pressure remains fairly constant until the brain compliance threshold is reached. Then small increases in the size of a tumor can lead to large increases in intracranial pressure and thus drive down cerebral perfusion

5

General signs and symptoms of CNS tumors

headache
vomitting
mental status change

6

Focal signs and symptoms

papilledema
Seizures
focal neuro deficits

7

Stop at 17

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8

Subfalcine herniation

herniation of the cingulate gyrus under the falx cerebri.

May compress anterior cerebral artery and CVA

9

Diencephalic downward herniation

- may cause drowsiness, impaired vertical gaze or small pupils bilaterally

10

Uncal herniation

ipsilateral oculomotor nerve palsy and contra or ipsilateral hemiparesis

11

Upward herniation through tentorium

may cause ipsilateral oculomotor, horner, and contralateral hemiparesis

12

Tonsilar herniation

causes BP changes, weakness, respiratory disturbance, horner syndrome

13

T1 weighted MRI scan

Water is hypointense (dark); ie tumor, swelling, CSF darker than surrounding brain

Injected contrast that leaks across the disrupted BBB appears hyperintense with an increased signal or brighter than the surrounding brain.

14

T2 weighted MRI scan

CSF Edema and tumors appear hyperintense.

15

What does Glioma mean?

tumor derived from glial cells

16

Most common primary CNS tumors are gliomas, of glial origin

know

17

Low grade tumors most commonly seen in

younger population

18

High Grade Tumors more commonly seen in

those older than 50

19

Low grade tumor characteristics

well differentiated, show no nuclear atypia, and have low mitotic index.

20

Increasing de-differentiation, higher mitotic index, vascular proliferation, and necrosis determine higher tumor grade.

Know

21

How many tumor grades are there

4

22

radiation modalities

- conventional: no longer used
- conformal: tumor gets more dose while normal brain dose is reduced
- radiosurgery: high dose of conformal radiation given in a single fraction
- brachytherapy: insertion of radioactive material in tumor cavity

23

What is bad about conventional radiation

tumor tissue and normal tissue receive the same dose

24

Meningioma

outside of the brain (extra-axial) tumors characterized on MRI by diffuse enhancement and a DURAL TAIL.

Generally benign and resectable

May show seizures or focal signs due to brainstem compression. Remember that it is the second most common primary brain tumor

25

3rd most common primary brain tumor

Pituitary tumors

26

Classifications of pituitary tumors

- Microadenomas: most often hrmone secreting
- Macroadenomas: most often do not secrete hormones, often grow large enough to cause sompression and hypofunction of gland or pituitary stalkP

27

Pituitary tumors often compress what?

Optic chiasm

28

Acoustic neuroma also called

vestibular schwannoma- benign tumor of schwann cells surrounding CN VIII

- Benign slow growing tumors that often present with hearing loss, tinnitus, headache, dizziness, facial numbness or weakness

- treatment= observation, surgical excision, excellent outcome with experienced neurosurgeon

29

Primary CNS lymphoma

on the rise, due to malignant transformation on trafficking B lymphocytes. Highly chemo and radiosensitive tumor.

30

Most common brain neoplasm is really mets

most common sites for tumors to met from is Lung, breast, melanoma, colon